੨੧. ਸ਼ੂਕਰੋਗਚਿਕਿਤ੍ਸਿਤਮ੍

Meaning of the śloka

Now the treatment of disorders caused by śūka will be explained, as taught by the revered Dhanvantari.

Key terms

śūkadoṣa

The class of disorders whose treatment is introduced in this chapter.

abhighātanimitta

Arising from injury, included by the commentary under the omitted ‘other’ causes.

durbhāganimitta

A source category named by the commentary whose precise contextual sense requires specialist confirmation.

Dhanvantari

The authoritative teacher to whom the instruction is attributed.

Meaning of the śloka

After properly scraping the sarṣapī lesion, it should be dusted with astringent medicinal powders. A wound-healing oil should also be prepared from those same astringent substances.

Key terms

sarṣapī

The named lesion treated in this passage.

saṃlikhya

Having scraped or scarified the lesion.

kaṣāya

Astringent medicinal substances, understood here as powdered trees and as ingredients for the oil.

vraṇaropaṇa taila

An oil intended to promote healing of the wound.

Meaning of the śloka

For aṣṭhīlikā, leeches should be applied repeatedly. If the condition still does not subside, it should be removed in the manner prescribed for a kapha-granthi.

Key terms

aṣṭhīlikā

The named firm lesion treated in this passage.

jalaukā

A leech, used here for repeated blood removal.

kapha-granthi

A kapha-associated nodular swelling whose method of removal supplies the comparison.

śastra

A surgical instrument used for the stated removal.

Meaning of the śloka

A grathita lesion should be fomented regularly with tubular steam and covered with comfortably warm, well-oiled poultices. When a kumbhīkā lesion has reached suppuration, it should be opened; after it has been cleansed, healing should be promoted with oil prepared from triphalā, lodhra, tinduka, and āmrātaka.

Key terms

grathita

The named indurated or knotted lesion for which fomentation and poulticing are described.

nāḍīsveda

Fomentation in which heat or steam is conveyed through a tube.

upanāha

A warm, unctuous poultice or bandaged application.

kumbhīkā

The named lesion that is opened after reaching the suppurative stage.

vraṇaropaṇa

Promotion of wound healing after cleansing.

Meaning of the śloka

After applying leeches to alajī, the affected area should be irrigated. Oil prepared with decoctions of astringent trees is regarded as promoting healing.

Key terms

alajī

The classical disorder treated in this passage.

jalaukā

A leech used for bloodletting in the described historical treatment.

kaṣāyavṛkṣa

Astringent trees, such as plakṣa, whose decoctions are used to prepare the oil.

ropaṇa

Promoting the healing of the affected tissue.

Meaning of the śloka

The affected area, after gentle manipulation, should be irrigated with lukewarm balā oil. It should then be covered with a comfortably warm, unctuous poultice made with substances of the madhura group and ghee.

Key terms

balātaila

Oil prepared with balā, used here for lukewarm irrigation.

mṛdita

Gently pressed or manipulated before irrigation.

madhura

The sweet-category substances, explained by the commentary as kākolī and related drugs.

upanāha

A warm, unctuous poultice applied externally.

Meaning of the śloka

Sammūḍhapiḍakā should promptly be treated with leeches. When the swelling has matured, it is opened and then dressed with honey and ghee.

Key terms

sammūḍhapiḍakā

The classical localized swelling or eruption addressed here.

jalaukā

A leech used for bloodletting in the historical regimen.

paryāgatā

A lesion that has matured; the commentary glosses it as pakvā.

kṣaudrasarpis

Honey and ghee used together as a topical dressing.

Meaning of the śloka

When avamantha has suppurated and has been opened, oil prepared with dhava, aśvakarṇa, pattaṅga, sallakī, and tindukī is prescribed. In puṣkarikā, all treatment should be cooling: blood is removed with leeches and the area is irrigated with ghee. In loss of sensation, bloodletting is performed, a paste of madhura substances is applied, and very cool milk, sugarcane juice, and ghee are used for irrigation.

Key terms

avamantha

A classical disorder treated here after suppuration and opening.

puṣkarikā

A classical condition for which cooling measures and leech bloodletting are prescribed.

sparśahāni

Loss or impairment of tactile sensation in the affected area.

aśvakarṇa

A named tree described by the commentary as gandhamuṇḍa in the eastern region and as resembling aśvattha.

pattaṅga

A substance identified by the commentary as red sandalwood.

Meaning of the śloka

The physician should remove the lesion called uttamā with a hook. After removing it, the site should be dusted with medicinal powders combined with honey.

Key terms

uttamā piḍakā

The named lesion addressed in this passage.

baḍiśa

A hook described as the instrument for removing the lesion.

śodhana

The cleansing stage of wound management in the commentary.

ropaṇa

The healing stage for which healing substances are selected.

Meaning of the śloka

After the śataponaka lesion has been scraped, a rasakriyā preparation should be applied. Oil prepared with the group beginning with pṛthakparṇī should then be given. A knowledgeable physician should manage tvakpāka in the manner described for visarpa.

Key terms

śataponaka

The named lesion that the verse describes as having been scraped.

rasakriyā

A concentrated preparation described by the commentary as having a phāṇita-like consistency.

pṛthakparṇī

The first-named substance in the group used to prepare the medicated oil.

tvakpāka

A named disorder whose management is compared here with that of pittaja visarpa.

visarpa

The classical disease category used as the treatment comparison; the commentary specifies its pittaja form.

Meaning of the śloka

A blood-origin arbuda should also be managed in the manner described for a blood-origin vidradhi. Decoctions, pastes, ghee preparations, oils, powders, and rasakriyā, together with cleansing and healing measures, should be employed only after repeatedly assessing the condition. Drinking ghee, suitable purgation, bloodletting, and light food are also said to be beneficial. For arbuda, māṃsapāka, vidradhi, and tilakālaka, the physician should first give a guarded prognosis and then undertake the appropriate treatment carefully.

Key terms

śoṇitaja arbuda

A blood-origin arbuda; the commentary specifies raktārbuda of the genital organ.

vidradhi

A named swelling or lesion whose blood-origin treatment is used as the comparison.

śodhana

Cleansing measures selected according to the assessed stage of the lesion.

ropaṇa

Healing measures selected according to the assessed stage of the lesion.

pratyākhyāya

Giving a guarded or unfavorable prognosis before undertaking treatment.

tilakālaka

One of the named serious conditions for which the verse requires prognostic caution.

Meaning of the śloka

Thus ends the twenty-first chapter of the Cikitsāsthāna in the Suśruta Saṃhitā, entitled ‘Treatment of Śūkaroga.’

Key terms

Cikitsāsthāna

The section of the Suśruta Saṃhitā devoted to treatment.

Śūkarogacikitsita

The chapter title, meaning the treatment of Śūkaroga.

Nibandhasaṅgraha

The title of Dalhaṇa’s commentary on the Suśruta Saṃhitā.